Part V: The Life and Contributions of Bennet Omalu MD

“So, we fought the battle on the pages of Neurosurgery.  We fought the battle scientifically.  Because the NFL didn’t stop.  They kept on coming at me.  I kept on defending myself.  There were some other doctors who said, “oh, you’re wrong.  It’s not CTE.”  They have not proven me wrong.  In fact, the science has developed.  When it comes to neuroscience, CTE is the single most financed research in the military now.  CTE.  The long-term effects of brain trauma.  Other researchers independently across the world have confirmed and reaffirmed what I said and carried the science foreword from there.  Afterall, isn’t that what science is all about?”

According to Omalu, the NFL wants to make it about concussions now, preventing concussions and thus preventing brain injury.  When, in fact, his work suggests it was never about concussions in the first place.  While important to prevent them, it is in fact the very game of football itself that inherently predisposes to brain damage, and on every single play.  It is about impact, whether or not that impact is directed to the head, as the brain is mobile in its casing and is jarred when a player in rapid motion falls down or is made to fall.  The sport of football itself is inherently dangerous. 

Human Beings were not evolutionarily adapted to repetitive head trauma, like Big Horn Sheep or Woodpeckers whose brains are better cushioned to absorb trauma.   Researchers at Boston University published a study in the Journal of the American Medical Association in July 2017 that examined the brains of 202 deceased American football players and found that 110 out of 111 former NFL players (99%) had evidence of Chronic Traumatic Encephalopathy on pathologic examination of their brains.  Additionally, CTE was also present in 91% of college football players and 21% of high school players.  A later study, by Ann McKee et al., who has become a leader in brain CTE research and a less controversial persona than Omalu, examined the brains of 152 deceased athletes under the age of 30 who played contact sports.  Published in JAMA Neurology on August 28, 2023, it found 41.4% had histological evidence of CTE.  This study showed that CTE could also affect our amateur athletes.  If there is a rainbow in this information it is that, fortunately, symptoms don’t always match the pathology.  It is obvious that not everyone who has ever played football or other contact sports has developed clinical symptoms of CTE, but it is likely that they all have pathologic evidence of some degree of CTE.  Omalu states, “I have yet to examine the brain of a professional football player who did not have CTE (pathologically).   It’s not about concussions.  It’s about cumulative exposure to blows to the head.”  It’s very likely that because Omalu was the first, he took the brunt of the football industries initial fear and anger on the subject and its uncouth response.

Omalu knew that he was on to something important.  He not only felt it in his gut, but he could see it play out in the histories of these football players, and now he could point to it in their brains.  But he also knew from his Epidemiology training that the first two cases could be considered sentinel cases, even coincidence, although he strongly doubted they were.  When the third case came along, Andre Waters, well, that was a trend now, and in the world of epidemiology, that was a game-changer.

One month after Omalu’s second paper was published, on Terry Long, he received a call from Chris Nowinski, who later worked for the Sports Legacy Institute at the Boston University Center for the Study of Chronic Traumatic Encephalopathy, which houses and studies the brains of athletes since 2008.  (This institute was a direct outgrowth of the effect Omalu’s findings had on the medical world.  Although not associated or affiliated with Omalu, it is a byproduct of his legacy to the world).  Nowinski said another NFL player had died, Andre Waters, and asked if he could convince the family to study the brain for CTE.  Omalu agreed and he was able to convince Andre’s mother, Willie Ola Perry.  Waters was one of eleven children.  His nickname was Dirty Waters because of the punishing hits he delivered to his opponents.  He played twelve years in the NFL, mostly for the Philadelphia Eagles and was said to have had at least fifteen concussions, per Omalu.  After he retired, Waters became increasingly forgetful, becoming lost in familiar areas of the city where he lived.  He developed mood swings, personality changes, and became increasingly isolated. On November 20, 2006, he committed suicide by self-inflicted gunshot wound to the head. Afterwards, Omalu studied the brain and confirmed the presence of CTE.  “Football killed him.”  It was becoming a familiar story, and with similar pathology on neurohistologic examination to make the connection between behavioral issues, CTE, and suicide.  Just two years later, Omalu would pen another article, this time in the American Journal of Forensic Medicine, Chronic Traumatic Encephalopathy, suicides and parasuicides in Professional American Athletes., Omalu, Bailes, Hammers, and Fitzsimmons, Volume 31, March 2010, detailing the deaths of four NFL football players and one professional wrestler.

After Andre Waters suicide, Omalu’s abuse intensified.  “The NFL doctors began referring to me with all sorts of adjectives across all media.  They made it sound like I was a dangerous human being who could not be trusted, an outsider, a foreigner who was attacking the American way of life.  Then phone calls started coming to the house--threatening calls.  I did my best to ignore them, but I could see the toll they were taking on Prema, my wife.  The phone calls grew more threatening.  People told me to go back to the jungle where I had come from.  They threatened me and my family.  I then started noticing cars following me.  And I wasn’t just being paranoid.” 

Publicly, those affiliated with the NFL continued to hammer away at Bennet Omalu’s findings in a cascade of attacks that illustrate the intersection between medicine, sports, and the corporate influence of the NFL, which had, after all, funded its own in-house study of concussion under the guise of the MTBI Committee.  Commented Congressman John Conyers in 2009:  The NFL sort of reminds me of the tobacco companies pre-1990’s…It’s the same things.  They’ve got the data, and they’re just hiding it.” 

The following responses from those associated with the NFL underscore the duplicity:

 In 2005, Dr. Elliot Pellman, long time New York Jets team physician, and rheumatologist, who attended the “esteemed” University of Guadalajara medical school, and chairman of the NFL MTBI committee declared, “My job is to take care of the players. I don’t believe the issue of concussions is as bad as some people say.”   Pellman was said to be very soft on concussion treatment as illustrated by the Wayne Chrebet incident on November 2, 2003, When the New York Jets played the New York Giants.  Chrebet suffered a concussion after absorbing a knee to the back of his head.  He was removed from the game and examined by Pellman, who reportedly told Chrebet “This is a very important (game) for your career,” and allowed Chrebet to re-enter the game.  Afterwards, Chrebet suffered from post-concussion syndrome and missed the rest of the season. (NFL concussion litigation, PBS “League of Denial,” series, and ESPN article “Doctor Yes.”)

NFL spokesman Greg Aiello (2005): We have been studying concussions for years with independent experts and published our findings.  We do not believe that Dr. Omalu’s paper represents valid science.”

Dr. Ira Casson, co-chair of the NFL MTBI Committee was, surprisingly, a neurologist.  In testimony before congress in 2009, Casson has this to say:  There is not enough valid, reliable, or objective scientific evidence to determine whether or not repeat head impacts in professional football result in long-term brain damage.” 

Dr. Omalu did not consider himself a whistleblower.  His sole intent was to call attention to the matter of the possible consequences of playing football.  He expected the NFL to embrace his discovery and work to change the culture of how to better safely conduct the game of football, to let Omalu’s findings usher in a new beginning.  In other words, there was the world before the atomic bomb, and there was the world after the atomic bomb.  The dichotomy was that simple.  There was football prior to definitive scientific proof of serious brain damage to its participants, and there was football after this dramatic revelation.  Could things really go on without acknowledgement and implementation of drastic change after this ground-breaking discovery?  Amazingly, that is exactly what happened.  The NFL decided to proceed with life as usual. 

After Omalu’s second paper, the MTBI Committee again dismissed his findings.  The NFL and its media surrogates continued to portray him as sensationalistic and not a credible source of information.  He began to face increasing professional isolation due to his professional stance.  He lost his job, there were both subtle and overt efforts to remove him from continued research on CTE, and efforts to continue to try to marginalize his credentials.  His access to brains from deceased former NFL players became restricted. These events crushed Omalu’s spirit, and, unable to rationally explain the circumstances, he began a slow, deep dive into the depths of another episode of major depression. 

“They tried to retract my paper.  The (NFL) hired consultants who used newspapers and journalists and other physicians to discredit me.  One time I was at a conference, and I heard a woman speaking about me with about ten men.  She was saying all types of offensive things about me.  I came into the circle and said, “Excuse me, have you ever met Dr. Omalu?  She said “no, and I don’t want to meet him.” I said, “then where did you get all these things you’re saying about me?   Because I am Dr. Omalu, and we’ve never met.”  She just walked away.  She didn’t even know me, but she was talking with authority.  I applied for a grant from the National Institutes of Health (the NIH) to study CTE.  I didn’t get the grant.  Imagine.  A lawyer who was working for the NFL told me that the league reached out to media executives to tell them to stop interviewing me.  A meeting was also held where any corporation that made money (by being involved with the) NFL was advised not acknowledge me on their media platforms.  They said, “There’s a relationship here, and if you want to keep that relationship….” Before I knew it, I was shut out of everything.”